Tsao J C, Lewin M R, Craske M G
UCLA Anxiety Disorders Behavioral Program, Department of Psychology 90095-1563, USA.
J Anxiety Disord. 1998 Jul-Aug;12(4):357-71. doi: 10.1016/s0887-6185(98)00020-6.
In a replication and extension of prior research (Brown, Antony, & Barlow, 1995) examining the impact of treatment on additional diagnoses, our study investigated the effects of cognitive-behavioral treatment for panic disorder on frequency and severity of comorbid conditions in 33 principal panic disorder patients. Patients were diagnosed using the Anxiety Disorders Interview Schedule-Revised (ADIS-R; Di Nardo & Barlow, 1988) and assigned severity ratings indicating degree of distress and/or impairment for both principal panic disorder and comorbid conditions. A high rate of comorbidity (63.6%) was found at pretreatment. Following cognitive-behavioral treatment, there was a significant reduction in the number of patients with at least one additional diagnosis (p < .01); the greatest declines were found in comorbid social phobia and generalized anxiety disorder. Severity ratings also declined significantly from pre- to posttreatment for comorbid social phobia, generalized anxiety disorder, and posttraumatic stress disorder (p < .01) and were marginally significant for depression. There was a trend for comorbidity to reduce likelihood of achieving high improvement in panic at posttreatment. Implications of these findings for classification and treatment mechanisms are discussed.
在一项对先前研究（Brown、Antony和Barlow，1995年）的重复及扩展研究中，该研究考察了治疗对额外诊断的影响，我们的研究调查了针对33名主要惊恐障碍患者的惊恐障碍认知行为治疗对共病状况的频率和严重程度的影响。使用焦虑障碍访谈量表修订版（ADIS-R；Di Nardo和Barlow，1988年）对患者进行诊断，并为主要惊恐障碍和共病状况指定严重程度评分，以表明痛苦和/或损害程度。在治疗前发现共病率很高（63.6%）。认知行为治疗后，至少有一种额外诊断的患者数量显著减少（p < .01）；共病社交恐惧症和广泛性焦虑障碍的减少最为明显。共病社交恐惧症、广泛性焦虑障碍和创伤后应激障碍的严重程度评分从治疗前到治疗后也显著下降（p < .01），抑郁症的严重程度评分有边缘显著性下降。共病有降低治疗后惊恐症状高度改善可能性的趋势。讨论了这些发现对分类和治疗机制的意义。
